As climate change is increasingly recognized as a global problem, better understanding of its potential impacts on human health gains urgency. Improved scientific understanding of the relationship between climate change and health can contribute to developing interventions to reduce vulnerability to climate change and ensuring that mitigation efforts to reduce greenhouse gas emissions address health impacts.
The results of this analysis suggest some relatively straightforward, and in some cases low-cost, approaches to advancing climate and health research at the NIH. For example, through identifying individual grants on the human health effects of climate change, this analysis enabled us to also identify the funding programs that have led to relevant and successful grant applications. By highlighting these relevant opportunities [e.g., in a Notice in the NIH Guide for Grants and Contracts
)], we have sought to encourage greater use of existing funding opportunities to expand the NIH portfolio in this area.
In addition, the analysis revealed that the three RCDC categories that the agency uses to identify and report climate and health grants could possibly be refined: 86 projects identified by IC representatives were not captured in the combined category, and > 40% of the projects captured in the combined category were deemed not to be relevant to climate and health upon manual examination (559 tier 4 projects). Whether research on UV radiation exposure related to stratospheric ozone depletion is relevant to climate change is controversial. Because the USGCRP considers both climate change and stratospheric ozone depletion to be aspects of global change, NIH has traditionally included a substantial portion of its UV effects studies in its climate change portfolio, which is reported to the USGCRP. Although accumulating greenhouse gases also contribute to stratospheric ozone depletion by enhancing the catalyzed destruction of ozone by chlorofluorocarbons, UV-induced skin cancer is not generally considered a consequence of global climate change. In keeping with historic NIH reporting precedence, however, we have included skin cancer studies in our analysis, but have excluded studies in which UV radiation was used solely as a DNA damaging agent in laboratory settings to understand basic cellular mechanisms. Were studies of ultraviolet exposure and associated skin cancers to be omitted from our lists, the number of overall studies specific to global climate change health effects would be smaller. Specifically, the total number of tier 1 and tier 2 projects would be 59 instead of 92. The distribution of projects into subcategories would also change: The number of cancer-related projects would drop to nearly zero, the number of laboratory studies would be reduced by half, and the representation of basic research would be reduced by two-thirds.
Research funding on climate change and health in countries other than the United States appears to be increasing. Although data are not readily available for all countries that note ongoing research on the topic, a recent review from Canada (Ford et al. 2011
) and the Medical Research Council of Australia’s website (National Health and Medical Research Council 2011
) demonstrate significant growth over the past decade. Canada’s investment rose from $160,000 (Canadian dollars) for five projects in 1999–2000 to around $5 million in 2008–2009, supporting 45 projects. Similarly, Australia’s research funding grew from $124,000 supporting one project in 2002 to $1.2 million (Australian dollars) supporting seven projects in 2008, and a forecast of $2.6 million for 14 projects in 2011.
The growing interest in addressing climate and health research needs has led to increased activities at the NIH. Through its basic and clinical research mission and portfolio, the NIH has been increasing its investment in research to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change are affecting and may continue to affect both domestic and global health. The NIH has begun to invest explicitly in priority climate and health research through targeted funding opportunities.
The Trans-NIH Working Group on Climate Change and Health (NIH 2012e
) was formed in 2007, and has facilitated the development of several recent climate-related funding announcements. In 2009, the NIH released an announcement to fund climate change and health research projects through the American Recovery and Reinvestment Act (ARRA). Five projects were funded through this solicitation (see ARRA 2010 for a description of the activities). These projects focused on how current climate and future climate change might affect human health, including heat-related morbidity and mortality, respiratory and cardiovascular impacts of air pollution (especially during wildfires), cholera, and mass human migration.
In June 2010, the NIH released a Notice to Highlight Current NIH Funding Opportunities that Promote Research on the Human Health Effects of Climate Change
(NOT-TW-10-008; NIH 2010b
). The notice identified five funding opportunity announcements linked to previous support for climate change and health research, and seven indirectly related to climate change and health research.
In July 2010, the NIH’s National Institute of Environmental Health Sciences (NIEHS) released a funding opportunity announcement titled Climate Change and Health: Assessing and Modeling Population Vulnerability to Climate Change
), in which eight other NIH ICs participated. The announcement encouraged the submission of multidisciplinary research proposals to examine the differential risk factors of populations that are associated with increased vulnerability to climate change in order to help inform climate change adaptation and public health interventions to reduce current and future vulnerability of various populations to the health effects of climate change.
Although interest in the health impacts of climate change is growing, and funding for research is gradually increasing, the broad, complex, and mostly indirect relationship between climate and human health, and the multidecadal time scale of climate change pose challenges for biomedical research. Furthermore, the overwhelming majority of NIH research is on basic biology underlying health and disease. Population-based epidemiology and intervention studies of the sort that are most closely aligned to the questions of climate change impact and adaptation needs have historically been a modest portion of the NIH portfolio. For example, another population-based field, rural health, funded approximately 481 grants in the same year as those in our study (NIH 2012b
), which is more than the 85 projects in our tiers 1 and 2, but less than the 798 projects in tiers 1, 2, and 3 in our study. However, as a result of internal discussions as well as calls from the general public, Congress, and the research community, NIH has in recent years increasingly invested in translational research (e.g., NIH 2011
) and implementation science (Madon et al. 2007
The topic of climate change and health, whose burdens are diffuse and largely projected, is in many ways more challenging to address than emerging biomedical issues whose disease burdens are more immediate and apparent. Research on climate and health requires multidisciplinary teams that can include meteorologists, climatologists, mathematicians and statisticians, computational scientists, and a diversity of health scientists. Throughout research there is a growing emphasis on team science and the recognition of its importance to productivity and its role in solving large problems (e.g., Hall et al. 2012
). Nonetheless, a key challenge to climate and health research is that most researchers are not cross-trained in both the earth and health sciences, and they tend to ask different questions and work at different temporal and spatial scales. Therefore, there is a need to train individuals across disciplines and to fund multidisciplinary teams to help ensure effective collaboration and high-quality science. Agencies that support climate and health research might encourage such multidisciplinary research in their solicitations and peer review, and might collaborate more with agencies having complementary missions and expertise in climate science, mathematical modeling of populations, human health surveillance, and ecological and agricultural research.
Analyses such as the one presented here are part of the process of identifying and addressing research gaps. As is the case in the development of any new field, working with a broad research community to identify priority research needs and opportunities is required. To this end, in December 2009, the Trans-NIH Working Group on Climate Change and Health convened a group of health researchers and climate experts to present and discuss these needs and opportunities. Their Priorities for NIH Research on Climate Change and Health Workshop featured analyses of historical NIH activities in the area, and included presentations by recent NIH climate change and health grantees supported by ARRA challenge grant funding and other scientists from the extramural community (Taylor 2010
). The workshop participants identified some priority research opportunities at the population level that informed the subsequent funding opportunity announcement (NIH 2010c
), and these have continued to inform the development of climate change and health research activities at the NIH. We have also opened a discussion with science and policy communities about government-wide needs and opportunities and how the NIH’s particular strengths in human health research can best contribute to understanding the implications of global climate change.
We conclude with some observations. First, similar to other areas of biomedical sciences, fiscal resources for making desirable investments to advance this field are likely to be constrained in the near to medium term by broad fiscal pressures on all government funding agencies. Second, many NIH ICs have roles in this field because of the diversity of potential health effects and their associated research needs. Third, the complexity of the field and the need for multidisciplinary collaboration with scientists beyond the traditional NIH-supported community calls for improved coordination to encourage the participation of multiple relevant agencies in supporting climate and health research. Given the nature and scale of the potential effects of climate change on the planet and on human health, and the degree of uncertainty that we face about these effects, we think that these issues are worth addressing.